In a nutshell
This study investigated the impact of interim functional imaging (IFI) on the outcomes of treatment for advanced classical Hodgkin lymphoma (cHL). This study found that patients with positive scan results were more likely to disease progression.
ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) is the most commonly used chemotherapy regimen for advanced cHL. Escalated (high-dose) BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) chemotherapy is also used. Up to 30% of patients develop refractory (does not respond to treatment) or relapsed disease after treatment. Alternative options are needed for these patients.
Medical imaging is used during treatment (interim) to evaluate how well a patient is responding to therapy. Depending on the imaging results, treatment can be decreased, increased, or changed to a different therapy. Whether using IFI during treatment is associated with better outcomes for patients with advanced cHL remains unclear.
Methods & findings
This study included 124 patients with advanced cHL. Patients received either ABVD chemotherapy only (67.7%) or combined with high-dose BEACOPP (32.3%). Patients then received interim imaging. Patients were followed for an average of 40.9 months.
71% of patients had negative scan results (cancer is not present). 29% of patients had positive scan results (cancer still present). Having a positive scan result was significantly associated with a 4.6-fold higher risk of tumor growth or spread (disease progression).
3-year progression-free survival (patients still alive 3 years later without disease progression) was significantly higher for patients who had negative scan results versus patients who had positive results (81.7% vs. 48.3%). 3-year overall survival (patients still alive 3 years later) was similar (93.2% vs. 86.7%).
For patients who showed positive scan results, those treated with high-dose BEACOPP had a significantly higher 3-year PFS compared to patients treated with ABVD alone (58.7% vs. 39.7%).
The bottom line
This study found that patients with positive interim scan results experienced greater disease progression compared to patients who had negative results. The authors suggest that IFI can help guide therapy decisions for patients with advanced cHL.
The fine print
This study was retrospective, meaning it looked back in time to analyze data. This study also had a small number of patients. Larger studies are needed to confirm these results.
Talk to your care team about including interim imaging in your treatment plan.
Published By :
Clinical lymphoma, myeloma & leukemia
Jan 01, 2019
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